The arrival of a new leadership team in Brussels provides an opportunity for Europe to reinvigorate its role as a global development power and to build a true partnership with its continental neighbour, Africa. These tasks have never been more urgent. Read here for recommendations on global health policy.
Understanding the Opportunity Cost, Seizing the Opportunity: Key Takeaways for Evidence-Informed Universal Health Coverage
The World Health Organization routinely develops and issues guidelines on how best to prevent, diagnose, and treat particular medical conditions. The guidelines are developed through a process determined by the WHO Guidelines Review Committee—a key part of which involves systematic evidence appraisal using the GRADE approach.
What’s In, What’s Out: Designing Benefits for Universal Health Coverage: Key Messages for Donors and Advocates
Many low- and middle-income countries aspire to universal health coverage (UHC), but for rhetoric to become reality, the health services offered must be consistent with the funds available, which may require tough tradeoffs. An explicit health benefits package—a defined list of services that are and are not subsidized—is essential in creating a sustainable UHC system.
Good Quality Evaluations for Good Policy: Findings and Recommendations from Aid Agency Evaluations in Global Health
Evaluations are key to learning and accountability yet their usefulness depends on the quality of their evidence and analysis. This brief summarizes the key findings of a CGD Working Paper that assessed the quality of aid agency evaluations in global health. By looking at a representative sample of evaluations—both impact and performance evaluations—from major health funders, the study authors developed 10 recommendations to improve the quality of such evaluations and, consequently, increase their usefulness.
Attention presidential transition teams: The first hundred days of the new administration should kick start an ambitious agenda in global health alongside long-needed reforms to enhance the efficiency and effectiveness of US action. Building on our earlier work, we suggest seven priority actions within three broad categories.
Since 2015, India has devolved an increasing share of its national tax yield to state governments and undertaken reforms to other kinds of centre-to-state grants. For many, the increased revenue via the tax devolution was considered good news but some health experts worried that states would give little priority to health under these conditions of greater autonomy. We find that at least two states, Bihar and Uttar Pradesh, have much more to spend in general and are budgeting more for health in 2015-2016 as compared to previous fiscal years.
The United States Government has the requisite technical know-how, financial and logistical resources, and bipartisan political support to lead the response to enduring global health challenges, and it is critical that the United States is prepared to meet them. This memo’s six recommendations are the result of a roundtable discussion on how the next administration and Congress can update and improve on the US global health engagement model.
Making Room for Mental Health: Recommendations for Improving Mental Health Care in Low- and Middle-Income Countries
Development assistance for health has increased dramatically over the last decade, but investment in mental health has been minimal. Less than 1 percent of development assistance for health goes to mental disorders although they represent at least one-fourth of the years lost to disability and about 10 percent of the global burden of disease. Spending a little on mental health could achieve a lot.
Many researchers and policymakers have hypothesized that funding models tying grant payments to achieved and verified results — next generation financing models — offer an opportunity for global health funders to push forward their strategic interests and accelerate the impact of their investments. This brief, summarizing the conclusions of a CGD working group on the topic, outlines concrete steps global health funders can take to change the basis of payment of their grants from expenses (inputs) to outputs, outcomes, or impact.
In the absence of effective international institutions, the United States has become the world’s de facto first responder for global health crises such as HIV/AIDS and new threats like Ebola. The US government has the technical know-how, financial and logistical resources, and unparalleled political support to act quickly and save lives. Initiatives such as the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative are widely considered among the most effective aid programs in the world.
Yet US global health approaches are based on increasingly outdated engagement models, which fail to reflect emerging challenges, threats, and financial constraints. The next US president, working closely with Congress, should modernize how US global health programs are organized, deployed, and overseen. By taking three specific steps, the United States can reduce the need for costly first responses and generate more health and economic impact for every US taxpayer dollar spent.
Remarkable progress has been made in the global fight against HIV/AIDS. The number of people receiving treatment in low- and middle-income countries increased from 300,000 in 2003 to 13.7 million in 2015, including 7 million supported by the United States. These gains are primarily attributable to a 2003 US government initiative called PEPFAR (the President’s Emergency Plan for AIDS Relief) that provided major new multiyear funding for global HIV/AIDS and created a new entity, the Office of the Global AIDS Coordinator, headed by an ambassador-rank Global AIDS Coordinator who is authorized to allocate PEPFAR’s resources and coordinate all US bilateral and multilateral activities on HIV/AIDS.
However, without dramatic changes to PEPFAR, the next president risks being held responsible for the failure of a program that until now has been one of the United States’ proudest foreign assistance achievements. And because PEPFAR is a major component of US foreign assistance spending, the next president’s choices about PEPFAR will heavily influence any subsequent assessments of his or her humanitarian foreign assistance policies.
Gavi, the Vaccine Alliance, pools donor funds to increase immunization rates in developing countries. Vaccines have saved millions of lives. Results from new research at the Center for Global Development suggest Gavi could save more lives by shifting support away from lower-cost vaccines provided to middle-income countries toward more underused vaccines and support to the poorest countries.
This brief presents a framework for increasing the efficiency of malaria-control initiatives that addresses where to intervene, what interventions are best, and how to deliver them most effectively.
Decisions about which type of patients receive what interventions, when, and at what cost often result from ad hoc, nontransparent processes driven more by inertia and interest groups than by science, ethics, and the public interest. Reallocating a portion of public and donor monies toward the most cost-effective health interventions would save more lives and promote health equity.
This brief summarizes and updates results of the Quality of Official Development Assistance (QuODA) index applied to health aid and compares these results to the overall QuODA assessment. Through quantifying performance on aid effectiveness, we hope to motivate improvements in health aid effectiveness and contribute to the definition of better, more empirically based measures of health aid quality.
Global Health and the New Bottom Billion: How Funders Should Respond to Shifts in Global Poverty and Disease Burden
After a decade of rapid economic growth, many developing countries have attained middle-income status, but poverty reduction in these countries has not kept pace with economic growth. Most of the world’s poor—up to a billion people—now live in these new middle-income countries. These countries also carry the majority of the global disease burden.
This brief summarizes the recommendations in Achieving an AIDS Transition to use focused policies and well-designed incentives to finally bring the AIDS epidemic under control.
Safer, Faster, Cheaper: Improving Clinical Trials and Regulatory Pathways to Fight Neglected Diseases (CGD Brief)
This brief outlines the recommendations from the report of the Center for Global Development’s Working Group on Clinical Trials and Regulatory Pathways